Single-cell transcriptomic analysis reveals cellular and molecular changes in EGFR-positive lung adenocarcinoma

Jian Chen1, Minghui Cai2, Lifei Meng1

  • 1Department of Thoracic Surgery, The First Affiliated Hospital of Ningbo University, Ningbo, China.

Genes & Genomics
|November 27, 2025
PubMed
Abstract

Insights

Furmonertinib treatment reshapes the tumor microenvironment in EGFR-positive lung adenocarcinoma, altering immune cell populations and communication pathways. This adaptation offers insights into targeted therapy response and resistance mechanisms.

Area of Science:

  • Oncology
  • Immunology
  • Genomics

Background:

  • Lung adenocarcinoma (LUAD) often has EGFR mutations, making EGFR tyrosine kinase inhibitors (EGFR-TKIs) crucial.
  • Third-generation EGFR-TKIs like Furmonertinib improve outcomes but face resistance.
  • Mechanisms of Furmonertinib response and adaptation, especially in the tumor microenvironment (TME), require further study.

Purpose of the Study:

  • To investigate the cellular and molecular changes in EGFR-positive LUAD after Furmonertinib treatment.
  • To analyze the impact of Furmonertinib on the tumor microenvironment (TME) and intercellular communication.
  • To elucidate mechanisms underlying response and resistance to Furmonertinib therapy.

Main Methods:

  • Single-cell RNA sequencing of tumor and adjacent tissues from EGFR-positive LUAD patients before and after Furmonertinib treatment.
  • Integration of public and in-house single-cell datasets.
  • Systematic analysis of cellular composition, gene expression, pathway enrichment, and ligand-receptor interactions.

Main Results:

  • Furmonertinib treatment reduced tumor cell proportion and remodeled the TME, increasing T cell infiltration and decreasing exhausted CD8+ T cells.
  • Enrichment of cancer-associated fibroblasts and monocytes was observed post-treatment.
  • Tumor cells showed increased EGFR expression and transcriptomic reprogramming, with altered signaling, immune, and differentiation pathways. Cell-cell communication shifted, attenuating immunosuppressive signaling and enhancing LAMC1- and EGFR-related pathways.

Conclusions:

  • Furmonertinib therapy induces significant cellular and molecular changes in EGFR-positive LUAD, including TME remodeling and transcriptomic adaptation.
  • Reprogramming of intercellular communication networks provides insight into Furmonertinib response and resistance.
  • Findings may guide strategies for optimizing EGFR-TKI therapy in LUAD.